Organization
HORIZON TYLER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN J KERN (SENIOR VICE PRESIDENT)
(941) 925-3490
Entity
Organization
Contact information
Practice address
906 E FRONT ST, TYLER, TX 75702-8328
(903) 593-8114
(903) 593-8144
Mailing address
240 N WASHINGTON BLVD, SARASOTA, FL 34236-5945
(941) 925-3490
(941) 953-4452
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0341DC
BCBS PROV #
TX
01
—
2241634
FIRST HEALTH
—
01
—
P00035829
RAILROAD MCARE PROV #
—
Enumeration date
05/24/2005
Last updated
08/22/2020
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